To biopsy or not to biopsy? Outcomes following stereotactic body radiotherapy (SBRT) for biopsy-confirmed versus radiologically-diagnosed primary lung cancer in a single Australian institution.

Autor: Koh TL; Department of Radiation Oncology, Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Heidelberg, VIC, Australia., Ong WL; Department of Radiation Oncology, Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Heidelberg, VIC, Australia.; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia.; Center for Digital Transformation of Health, The University of Melbourne, Melbourne, VIC, Australia.; School of Clinical Medicine, University of Cambridge, Cambridge, UK., Farrugia B; Department of Radiation Oncology, Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Heidelberg, VIC, Australia., Leong T; Department of Respiratory Medicine, Austin Health, Heidelberg, VIC, Australia.; Department of Medicine, University of Melbourne, Melbourne, VIC, Australia., Lapuz C; Department of Radiation Oncology, Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Heidelberg, VIC, Australia., Lim A; Department of Radiation Oncology, Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Heidelberg, VIC, Australia.
Jazyk: angličtina
Zdroj: Asia-Pacific journal of clinical oncology [Asia Pac J Clin Oncol] 2022 Jun; Vol. 18 (3), pp. 319-325. Date of Electronic Publication: 2021 Jun 29.
DOI: 10.1111/ajco.13614
Abstrakt: Introduction: Obtaining tissue diagnosis for lung cancer can sometimes be difficult and unsafe. We evaluated outcomes of biopsy-confirmed versus radiologically-diagnosed lung cancer treated with stereotactic body radiotherapy (SBRT).
Methods: A single-institutional retrospective cohort of lung cancer patients treated with SBRT between February 2014 and October 2018. Outcomes of interest were: local failure (LF), distant failure (DF), and overall survival (OS). Probability of LF, DF, and OS were estimated using the Kaplan-Meier method. Differences in outcomes between biopsy-confirmed versus radiologically-diagnosed lung cancer were evaluated using the log-rank test.
Results: Sixty-five lung lesions in 61 patients were treated with SBRT. Mean age was 75.6 years. Twenty-seven patients (44.3%) were ECOG 2-3. Thirty-nine patients (64%) were radiologically-diagnosed. There were five cases of LF observed at median of 12.8 months post-SBRT and 12-month LF-free survival was 96% (95% CI, 86-99%), with no differences between groups (p = 0.1). Sixteen patients developed DF, with 12-month DF-free survival of 84% (95% CI, 71-91%), and no difference between groups (p = 0.06). Sixteen deaths were reported at a median of 12.5 months post-SBRT, with 12-month OS of 85% (95% CI, 73-92%), and no differences between study groups (p = 0.5). No grade 3 toxicities were reported.
Conclusion: The oncological outcomes were similar in patients with early lung cancer treated with SBRT with or without biopsy-confirmation. In situations where tissue diagnosis is not feasible or unsafe, it is not unreasonable to offer SBRT based on clinical and radiological suspicion following multidisciplinary discussions.
(© 2021 John Wiley & Sons Australia, Ltd.)
Databáze: MEDLINE
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